Tom, a supervisor from marketing, notifies Rob that
he has been unhappy for a while with Rob's teamwork. Rob
eventually complains to Tom's boss that he is being singled
out unfairly by his incompetent supervisor. Things come to
a head in the company's cafeteria when Tom accuses Rob of
disloyalty and end-running. As anger-laced words fly back
and forth, a cascade of catecholamines is released into Tom
and Rob's brains and bloodstreams. Catecholamines are
hormones and neurotransmitters that, together with the
stress hormone cortisol, are main factors in the stress
response. They mobilize the body's resources in the
presence of perceived danger. As Tom and Rob raise their
voices, they are totally under the influence of these
endogenous chemicals. From dilation of the pupils to more
of their blood being sent to their brains, hearts, and
muscles, to glycogen being broken down to glucose in their
bloodstreams for fuel, they are in full fight-or-flight
alert.

This activation of their bodies' emergency systems,
however, is not without a price. Neurochemicals such as
epinephrine, norepinephrine, and cortisol increase blood
pressure, sometimes to dangerously high levels. They affect
the metabolism of cholesterol and triglycerides, which
contribute to atherosclerosis. Well known to weaken the
immune system, they block the activity of the macrophages
(the killers of tumor cells). Although one
catecholamine-assisted altercation will not kill Tom or
Rob, a repeated engagement of their stress response will
add substantially to the wear and tear of their organs and
blood vessels. If they find themselves often in the grip of
hostility and anger, they may sooner or later face serious
cardiovascular disease and other ailments. One of the
wisest things Tom and Rob can do for themselves is choosing
congeniality as their default mode of relating to the
world. This time, however, they go their separate ways in a
huff.

As children, most of us looked at good manners as
something between boring and burdensome that we were
expected to do, at our parents' prodding, for others' sake.
Growing up, we vaguely perceived good manners as good but
still saw them as benefiting others. This view has clear
merit. Civility, politeness, and good manners (which I
treat as one here) are indeed "something" we do for others.
We are civil when we believe that other people's claim to
comfort and happiness is as valid as our own, and we back
up belief with action (such as letting someone merge into
the flow of traffic).

Good manners, however, are also something we do for our own
sake. They are good for us because as a basic code of
relational skills they help us manage our relationships,
which are crucial to our well-being and health. Although as
adults we may have developed a more sophisticated
understanding of manners, chances are that our early bias
(that they are for others' sake) still looms large. This
may lead us to the wrong conclusion that in the fast-paced,
highly competitive and stress-laden environment in which we
live, good manners are a luxury we can't afford. I suggest
that we balance this view by looking instead at good
manners as a precious life-improvement tool for the very
people who have them. Maybe slowing down in the name of
kindness would allow us to connect meaningfully with
someone. Maybe this would help us in the pursuit of our
goals — both professional and personal. This is as
good a time as any to look at the other side of manners:
the expedient side.

"Manner" comes from manus, the Latin word for
"hand." Thus, manners are ways of handling. We exhibit good
manners when we handle well our daily encounters with
others — when we handle others, that is, with care
and consideration. As relational skills based on empathy,
good manners prove crucial when it comes to establishing
and maintaining connection and rapport. Humans are
hyper-social creatures. We inherited the genes of ancestors
who banded together and shared their prey at the end of the
day's hunt. Group identity inevitably shapes our personal
identity. "Plays well with others" defines the
well-adjusted child, and "team player" the employee every
workplace wants. If life is a relational experience, then
we'd better hone our abilities to relate. As hyper-social
beings, our happiness or unhappiness depends, to a large
extent, upon the quality of our relationships. As a general
rule, better manners mean more harmonious relationships and
thus an increased quality of life.

P.M. Forni

According to clinical psychologist Arthur Ciaramicoli, the
co-author, with Katherine Ketcham, of The Power of
Empathy, empathy benefits the very person who has this
emotional ability: "Individuals who have high relational
skills are more successful personally and professionally.
People who have developed the capacity for empathy, in
particular, have the ability to understand and respond to
others based on the facts discerned rather than with
generalities. When we know how to listen with compassion
and grace we will always attract others in whatever walk of
life we live. Corporate managers, educators, etc., all are
more successful when they have the ability to read others
accurately. Of course, in our personal lives, these
abilities make us better friends, spouses, and parents,"
Ketcham says.

By being good citizens of our little world of family and
friends, we build the foundation of our social support.
Common sense and good physicians agree: Social connections
are good for us. The meaningful presence of others in our
lives helps us remain healthy — both physically and
mentally. It is good to be a member of a family, a
religious congregation, a charity initiative, or a support
group. We all need loyal friends, empathetic co-workers,
good neighbors, and thoughtful strangers around us.
Isolation invites illness. To cope and thrive we need
social support. To build and manage social support,
however, we need social skills.

When we treat others with kindness and consideration, we
show them that we value them as persons. This motivates
them to remain in our lives, and as a result we continue to
enjoy the rewards of connecting. Until three or four
generations ago, a large amount of the support we needed
came from our extended families. Today, as we often turn to
friends, acquaintances, and even strangers for support and
care, being likable can be a substantial advantage. An
elementary but powerful truth to always keep in mind is
that social skills strengthen social bonds. Social skills
are thus an invaluable quality-of-life asset — in
fact, they are nothing less than determinants of
destiny.

The strengthening of social bonds gives us opportunities to
confide. Confiding is good medicine. As we open ourselves
up to a good listener, we get our sorrows off our chests,
gain insights into our predicaments, and invite sanity into
our lives. Disclosing is often the beginning of healing.
Pioneers in mind-body medicine such as James Pennebaker,
Janice Kiecolt-Glaser, and Ronald Glaser have paved the way
to the scientific realization that confiding is also good
for our immune system. There is a direct correlation
between self-disclosure and resistance to disease. It is in
part thanks to our relational skills that we manage to make
and keep the friends among whom we can choose our
confidants. The more trustworthy friends we have and the
closer we are to them, the more likely it is that we find
among them the right persons with whom to open up.

If you are considerate, people will like you and trust you;
if they like you and trust you, they will let you help
them; by helping them, you will help yourself. The ability
to maintain good relationships makes us successful at
helping and volunteering, which feels good and is good for
us. Researcher Allan Luks has studied extensively the state
of well-being he calls "helper's high." This state, similar
to a "runner's high," occurs in people who volunteer for
good causes. Luks believes that it is the release of
endorphins in the volunteer's body that allows him or her
to experience elation followed by calm. Although less
intensely, helper's high also occurs in volunteers when
they recall the experience of helping. Especially when it
is not felt as an obligation, helping appears to release
hormones and neurotransmitters that strengthen the immune
system and are generally good for your health.

Feeling good about ourselves and our relationships makes us
more inclined to laugh. From time immemorial, human beings
have felt that laughing is good for them. Now we have the
science to back up intuition. Laughter increases blood
flow, reduces the effects of stress (by reducing the amount
of cortisol, the stress hormone that can cause so much
cardiovascular damage), and gives our immune system a
boost. Laughter appears to be accompanied by the release of
endorphins, the biochemical compounds that suppress pain
and induce states of well-being. Happy people are less
likely to suffer from high blood pressure and heart
disease. The inclination to laugh seems to have a
protective effect on our hearts. Although our individual
propensity to laugh may be genetically programmed, the
circumstances of life will also determine the amount of
laughter we enjoy. Relational skills can make us happier
and give us the gift of much-needed hearty, healthful
laughs.

Common sense and good physicians agree: Social
connections are good for us. The meaningful presence of
others in our lives helps us remain
healthy.

Such positive emotions are not only good for our health,
they are good for our thinking as well, according to
psychiatrist and author Edward Hallowell: "Basically,
emotion acts as the doorkeeper to advanced thinking. When a
person is in a good mood, feeling content and in harmony
with his surroundings, the door is wide open. He can do
what his cerebral cortex is uniquely equipped to do: think
flexibly; perceive irony and humor; perceive shades of
gray, subtlety, complexity; bear with the frustration of
not knowing the answer, and allowing conflicting points of
view simultaneously to balance in his mind without either
overpowering the other; wait, before bringing premature
closure; ask for help; empathize with others; give to
others; put the needs of others before his own; give help;
inspire others."

Civility, according to Yale law professor Stephen
Carter, "is the sum of the many sacrifices we are called to
make for the sake of living together." In our times of
relentless self-indulgence, it is good to keep in mind that
restraint and sacrifice are necessary for functioning well
among others. Yes, sacrifice is part of civility. It is a
sacrifice, however, that we make for our own sake as well
as others'. (Also, we often reach a point where we do not
perceive acting civilly as a sacrifice anymore, but rather
as a necessary part of who we are.) Civility is powerfully
linked to expediency — it is a very efficient and
captivating way of pursuing self-interest.

Let us go back to Tom and Rob. In this second version of
events, instead of firing an angry salvo, Tom calls Rob to
his office and suggests that they try to resolve their
differences rationally and fairly. Tom admits to
criticizing Rob without giving him clear alternative
directions. In turn, Rob acknowledges giving Tom's boss an
unduly harsh assessment of Tom's abilities as a supervisor.
They both apologize and pledge remedial action. As they
reminisce about their long-standing employment in the
company, their contested issues seem to be settling
themselves, and the goodwill is almost palpable on both
sides. Although there is no fight-or-flight reaction this
time, it does not mean that their coming together in a
civil and congenial way has no neuroendocrine basis.

Just being in the friendly presence of one another rewards
Tom and Rob with lowering levels of stress and as a
consequence a better functioning of their immune systems.
Their stress reduction is aided by the release of the
hormone oxytocin, of growth hormone, and of EOPs, the brain
opioids. Their congenial mindset is connected to an
increased level of the neurotransmitter serotonin in their
brains. Together with keeping their hostility in check,
serotonin has the effect of invigorating their sense of
self-esteem, and thus makes them less defensive and more
cooperative. The oxytocin that, in the meanwhile, is
generously released, strengthens the social bond between
the two co-workers. Under the sway of their feel-good
hormones, Tom and Rob can think more clearly and in more
sophisticated ways. As their conversation wanders, they
exchange good, imaginative ideas on how to run their unit:
a welcome, unexpected result of a meeting called to
administer intensive care to a relationship between
co-workers.

P. M. Forni, author of Choosing Civility: The
Twenty-five Rules of Considerate Conduct, is a professor
in the Krieger School of Arts and Sciences' Department of Romance Languages and
Literatures. For the scientific background on this
essay, he consulted Johns Hopkins cardiologists Ilan
Wittstein and James Weiss, psychiatrist and author Edward
Hallowell, Harvard psychiatrist John Ratey, clinical
psychologist and author Arthur Ciaramicoli, Johns Hopkins
psychiatrist Rudolf Hoehn-Saric, University of Maryland
neurologist Stephen Reich, and Johns Hopkins neurologist
Guy McKhann. Dr. Forni extends a cordial thank you for
sharing their time and knowledge!